Illinois Caps Teledentistry Prophy Visits, Bars Hygienists From Applying SDF

Edited by Hygienetown staff

A new Illinois law spells out what a dental hygienist may and may not do at chairside when the supervising dentist is not in the room, capping patients at two prophylaxis visits under teledentistry before an in-person dentist examination and barring hygienists from applying silver diamine fluoride in those visits. Senate Bill 3211 became Public Act 104-0845 on Aug. 21 and takes effect Jan. 1, 2027.

The arrangement the section governs puts the hygienist with the patient and the dentist elsewhere. The act requires the teledentistry consent form to advise patients that the dentist is not physically present, and it defines a synchronous system as a real-time, two-way audiovisual interaction between the patient and a dentist or dental office.

Under the act, a dentist may delegate dental services by teledentistry to an Illinois-licensed hygienist only under the same supervision requirements the Illinois Dental Practice Act sets for in-person care.

Within that structure, a hygienist may perform oral prophylaxis procedures, apply fluoride treatments, and process radiographs as ordered by the supervising dentist, and only for a patient of record after an Illinois-licensed dentist has examined, diagnosed, and authorized the procedures using synchronous systems.

Fluoride is where the act draws a line. A hygienist working under teledentistry may apply fluoride treatments but not any product used for the remineralization of teeth, including but not limited to silver diamine fluoride.

Two further limits attach to remote-supervised prophylaxis. A patient may receive no more than two prophylaxis procedures performed by a hygienist through teledentistry before an in-person examination by a licensed dentist is completed. Local anesthetics and nitrous oxide may not be used during a teledentistry prophylaxis appointment.

The section closes by stating that nothing in it expands the scope of practice for dental hygienists or establishes independent hygiene practice.

Other provisions apply across the practice. An in-person clinical examination is required immediately before any service that is not reversible or that otherwise increases risk to the patient. Initial examinations for orthodontia, sleep apnea treatment, snoring treatment, and the functional and cosmetic replacement or treatment of teeth must be in person. Continuing patients are to be seen in person at least annually.

Hygienists providing teledentistry, like dentists, must give patients their name, direct telephone number, and physical practice address.

Sen. Michael E. Hastings led the measure in the Senate with 22 co-sponsors, and Rep. Robert “Bob” Rita led it in the House. The hygiene provisions arrived through Senate Committee Amendment No. 1, which replaced the bill’s original language and also defined “synchronous.”

The Illinois Department of Financial and Professional Regulation will write implementing rules, including minimum technology standards.

Sources:
Illinois General Assembly, Public Act 104-0845, full text: ilga.gov/Legislation/PublicActs/View/104-0845
Illinois General Assembly, SB 3211 bill status and sponsor history, 104th General Assembly: ilga.gov/Legislation/BillStatus/SB3211